Indian Journal of Medical Specialities最新文献

{"title":"Assessing the coverage of the pradhan mantri jan arogya yojana scheme and out-of-pocket expenditure in Mysore Urban slum dwellers","authors":"V. Vadaga, Deepak Anil, Shabeena Akbar, M. Murthy, S. Doddaiah","doi":"10.4103/injms.injms_92_22","DOIUrl":"https://doi.org/10.4103/injms.injms_92_22","url":null,"abstract":"Introduction: In 2018, the Government of India launched the Pradhan Mantri Jan Arogya Yojana (PM-JAY), a part of the Ayushman Bharat scheme as a progressive step toward universal health coverage. The scheme was intended to provide health insurance for the socioeconomically deprived population. This study was undertaken to assess the coverage of the scheme and to assess the reduction in medical out-of-pocket expenditure (OOPE). Methods: This was a cross-sectional study conducted among the urban slum dwellers in Mysuru. A semi-structured questionnaire was used for the study. Oral consent was taken from the participants before administering the questionnaire. Data were collected by face-to-face interviews. Statistical tests such as percentages and mean were calculated using SPSS software (Version 26, Licensed by JSSAHER). Results: The study was conducted among 104 individuals, of which 73% were females. Only 38 (33%) of the participants had PM-JAY cards while 59 (56.73%) did not have any health insurance. Thirty percentage (78.95%) of the card holders had utilized the insurance in the past 1 year and incurred an OOPE of Rs. 25,873/-. For all the cardholders, this amount was spent from their savings. Conclusion: The coverage of the scheme and OOPE reduction toward health care is still lacking. Greater measures need to be taken by medical officers, medicosocial workers, and other field workers to identify eligible households and help them avail the benefits of this scheme.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"22 - 25"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49500467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute bilateral retrobulbar optic neuritis revealing sphenoethmoidal sinus neuroendocrine carcinoma","authors":"Belfaiza Soukaina, M. Chatain, Benjelloul Fatiha","doi":"10.4103/injms.injms_130_22","DOIUrl":"https://doi.org/10.4103/injms.injms_130_22","url":null,"abstract":"Primary sinonasal neuroendocrine carcinoma is a rare tumor of extreme malignancy. The diagnosis is often made at an advanced stage. The most recently documented treatment for nonmetastatic paranasal sinus neuroendocrine carcinoma consists of chemotherapy (cisplatin-VP16) followed by radiotherapy. Surgery is reserved for resectable tumors that do not respond well to chemotherapy. We report the case of a patient admitted for acute bilateral Retrobulbular optic neuropathy (RBON) revealing a sphenoethmoidal sinus neuroendocrine carcinoma.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"60 - 62"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41922817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacteriological profile and antibiotic susceptibility patterns of Gram-negative bacilli isolated from lower respiratory tract infections","authors":"Divya Atray, S. Sheethal","doi":"10.4103/injms.injms_93_22","DOIUrl":"https://doi.org/10.4103/injms.injms_93_22","url":null,"abstract":"Background: Lower respiratory tract infections (LRTIs) are one of the most frequent infections seen in humans. Bacterial etiology of these infections is one of the major causes of morbidity and mortality. The emergence of drug resistance among bacteria is increasing throughout the world causing more severe infections because of their continuous mutation and multidrug resistance nature. Objectives: This study was focused on obtaining a comprehensive insight into the Gram-negative bacillary profile of LRTIs, their prevalence, and their antibiotic susceptibility patterns. Materials and Methods: The study was conducted for a duration of 6 months. Samples were obtained from patients of all ages and both sexes presenting with symptomatology suggestive of LRTIs. Following conventional culture, the isolated organisms were identified by various preliminary identification methods and biochemical tests. Antimicrobial sensitivity testing of Gram-negative isolates was performed by standard methods as recommended by CLSI 2019. Results: Out of the 1724 LRT specimens evaluated, 307 (17.80%) were culture positive. Our study showed that Gram-negative bacilli are the predominant cause (97.70%) of LRTIs with Klebsiella pneumoniae (42%) as the major pathogen followed by Escherichia coli (31.66%), Pseudomonas aeruginosa (25.33%), and Acinetobacter baumannii (1%). Extended-spectrum beta-lactamase production was detected in 3.33% and metallo-beta-lactamase in 2% of the total GNB pathogens. Conclusion: For effective management of LRTIs, an ultimate and detailed bacteriological diagnosis along with antimicrobial susceptibility testing is required to overcome the global problem of antibiotic resistance.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"31 - 36"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47186029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of severe acute respiratory syndrome-coronavirus-2 pandemic on postgraduate medical education in armed forces medical services institutions: A students' perspective","authors":"D. Mahapatra, N. Nair, Muhammad Ahsan Khan, V. Jha","doi":"10.4103/injms.injms_64_22","DOIUrl":"https://doi.org/10.4103/injms.injms_64_22","url":null,"abstract":"Introduction: The Severe acute respiratory syndrome coronavirus 2 pandemic situation brings us the opportunity to test the strength and limitations of our health delivery system. Residents being the backbone of quality-health-delivery of any institute have taken the brunt. Materials and Methods: A cross-sectional self-administered questionnaire-based survey was used to assess the effect on medical training and stress of postgraduate residents in clinical specialties of armed forces institutions. Results: 266 valid responses were analyzed. Eighty-seven percent of residents felt their surgical/procedure-related training was affected. Bedside/clinical training was found to be affected by 92% and theoretical learning by 78%. A significant difference was found between residents in medical and allied specialties and residents in surgery and allied specialties (81% vs. 96.3%) with regard to the negative effect of the COVID-19 pandemic on surgical/procedural skills training (P < 0.05). There was a significant difference in the likelihood of being posted for COVID duties based on gender (P = 0.01) and year of the course (P = 0.004). Posting on COVID duties did not significantly affect surgical, clinical, or theoretical training. Of the respondents, 37%, 49%, and 14% had a mild, moderate, and severe increase in stress, respectively. 18%, 52%, and 30% experienced mild, moderate, and severe increased stress among family members. Gender, age, category, year of residency, or subject of specialization did not have any significant effect on the level of personal or family stress. Conclusion: This survey attempts to bring forth the effect of the pandemic on medical training schedules and stress among residents. Such surveys would enhance understanding and bring solutions to the problem that the pandemic has brought.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"9 - 14"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47079009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A focal submucosal lipomatosis: An extremely rare cause of appendicitis","authors":"S. Chandanwale, P. Patel, A. Verma, Nirali H. Patel","doi":"10.4103/injms.injms_107_22","DOIUrl":"https://doi.org/10.4103/injms.injms_107_22","url":null,"abstract":"Gastrointestinal lipomatosis is less frequent condition and it differs from lipoma due to the lack of capsule. The most common location of gastrointestinal lipomatosis is colon, followed by the ileum and jejunum. Isolated lipomatosis of the appendix is rare. It can be diffuse, asymmetric, or focal. In the localized form, only few patients present with symptoms. Obstruction of the lumen of the appendix is thought to be the primary pathology of appendicitis. Various pathologies such as hard fecal mass, stones, lymphoid hyperplasia, and neoplasia have been implicated. Obstruction of the appendiceal lumen due to isolated submucosal lipomatosis of the appendix is extremely rare. It can be one of the causes of appendicitis. Although radiological modalities such as ultrasonography, computed tomography scan, and magnetic resonance imaging are used for diagnostic workups, definitive diagnosis requires histopathological examination.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"45 - 46"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48810069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of beneficiaries regarding quality of care and respectful maternity care being provided in delivery room using LaQshya guidelines","authors":"Chandragopal Dogne, J. Dudi, Nalini Dogne, S. Afrin, Abhay Singh, D. Raghunath, Salil Sakalle, V. Chellaiyan","doi":"10.4103/injms.injms_108_22","DOIUrl":"https://doi.org/10.4103/injms.injms_108_22","url":null,"abstract":"Introduction: Quality of care in labor room and maternity operation theatre is crucial so that every pregnant woman receives the most appropriate care with dignity and respect, which is her fundamental right. The present study was attempted to assess the satisfaction of beneficiaries of both rural and urban areas visiting the public health facilities with regard to the quality of care and Respectful Maternal Care (RMC). Methodology: The present study was carried out in the Department of Community Medicine, MGM Medical College Indore to assess the satisfaction of beneficiaries of both rural and urban areas visiting the public health facilities with regard to the quality of care and Respectful Maternity Care (RMC) for 1 year from June 2020 to June 2021. A scoring system was used and based on the perception of the beneficiaries on different parameters on the scale of 1–5 where 1 – poor, 2 – satisfactory, 3 – good, 4 – very good, and 5 was considered excellent. Results: The majority of beneficiaries were in the age group of 21–30 years. Statistically significant difference between rural and urban areas in parameters of beneficiaries with regards to various aspects of post-natal care, in parameter of explanation of treatment procedure, maintenance of privacy efforts put to not allow to feel lonely and treatment with dignity and respect between rural and urban areas. Conclusion: When all the parameters and subparameters of the perception of beneficiaries of quality of care and respectful maternity care (RMC) were analyzed in both rural and urban areas, statistically significant difference was observed.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"26 - 30"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49109651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of nonalcoholic fatty liver disease in hypothyroid subjects: A cross-sectional comparative study","authors":"Maharshi Patel, Sourya Acharya, Sunil Kumar","doi":"10.4103/injms.injms_24_23","DOIUrl":"https://doi.org/10.4103/injms.injms_24_23","url":null,"abstract":"Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. NAFLD has become the leading cause of liver disease globally. Hypothyroidism is a major factor in the development of NAFLD. Thus, the current investigation aimed to estimate the prevalence of NAFLD in individuals with hypothyroidism. Materials and Methods: This cross-sectional comparative study was conducted on 142 patients who qualified for the eligibility criteria. Proper history, examination, anthropometric measurements, and biochemical parameters were estimated. The collected data were entered in Excel and analyzed using the Statistical Package for Social Science 25 version developed by IBM (International Business Machine), IBM is a USA based company and the Student’s t-test and the Chi-square test were applied. Results: In this study, 12.6% of the treated subjects had fatty liver and 59.15% of the untreated subjects had fatty liver. From these untreated cases, fatty liver was found in 17.6% of subclinical hypothyroid subjects and 41.5% of overt hypothyroid subjects. There was a significant association between thyroid status and fatty liver (χ2 = 68.046, P < 0.001). Conclusions: We have found that NAFLD is more prevalent in untreated hypothyroid subjects. The severity of NAFLD is more in patients with overt hypothyroidism. Early treatment with thyroxine can prevent the progression of the fatty liver and grave consequences such as nonalcoholic steatohepatitis and cirrhosis.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135844884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of interleukin-6 levels in predicting COVID severity: A single-center experience","authors":"AnshuGupta Devra, Gurleen Gill","doi":"10.4103/injms.injms_39_23","DOIUrl":"https://doi.org/10.4103/injms.injms_39_23","url":null,"abstract":"The COVID-19 pandemic has changed the entire perspective of health-care scenario globally. Our fight against this virus is to enable ourselves to recognize early warning signs or biomarkers in those infected so that they can be allocated adequate health-care resources to decrease mortality and morbidity. It was for this reason that we analyzed the hematological parameter neutrophil-to-lymphocyte ratio (NLR) and inflammatory biomarker cytokine interleukin (IL)-6 to evaluate whether they can be used to predict the severity of COVID-19 infection and also to study if any significant association exist between the two. These parameters can be easily analyzed even in primary health-care setting to effectively triage patients requiring tertiary care/L-3 facilities. This study was conducted on 100 reverse transcription–polymerase chain reaction confirmed COVID-positive patients. The patients were then categorized into mild, moderate, and severe COVID at the time of admission according to the criteria laid down by symptoms and SpO2 levels at room air as defined by ICMR COVID guidelines by the Ministry of Health and Family Welfare[1] (MOHFW), Government of India, revised on January 14, 2022 – Mild disease – Upper respiratory tract symptoms and/or fever without shortness of breath or hypoxia Moderate disease – Any one of: Respiratory rate ≥24/min, SpO2: 90% to ≤93% on room air Severe disease – Any one of: Respiratory rate &gt;30/min, SpO2 &lt;90% on room air. For ease of comparison and to effectively evaluate high-risk patients, mild and moderate categories were clubbed together into nonsevere as they can be managed in L-2 facility. However, those falling in the severe category require L-3 facilities with advanced infrastructure and ICU facilities and are, therefore, categorized separately. Levels of IL-6 and NLR were compared between the two groups. NLR was derived by dividing the percentage of neutrophils to the percentage of lymphocytes after calculating differential leukocyte count taking the normal upper limit of NLR as 3.5, as identified by Forget et al.[2] for the adult nongeriatric population in good health.[2] The mean value of NLR in mild, moderate, and severe categories was 3.9, 3.1, and 6.7, respectively. On combining mild and moderate categories as nonsevere, the mean values of NLR obtained were 3.7, almost half of the NLR mean values observed in the severe category, i.e., 6.7. On applying the analysis of variance (ANOVA) t-test, a significant statistical correlation (P = 0.016) of NLR was found with clinical severity. Cytokine IL-6 is an inflammatory cytokine that has a role in different pathological conditions such as infections, inflammations, and in cancers. IL-6 is also considered the main culprit responsible for hyperinflammation, causing lung damage and eventually death in severe cases of COVID-19. The normal upper limit for IL-6 was set as 7 pg/ml. Out of 100 patients, those in the mild category had mean IL-6 levels of 30.8 pg/ml, moderate pat","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135844878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time spent in physical activity by ambulatory stroke patients and its comparison based on gait speed – A pilot study","authors":"Mansi Soni, Balaganapathy Muruganantham","doi":"10.4103/injms.injms_28_23","DOIUrl":"https://doi.org/10.4103/injms.injms_28_23","url":null,"abstract":"Introduction: Physical activity is proven to have beneficial effects in the prevention and management of stroke. This makes it an important modifiable risk factor Stroke is a condition resulting in various functional deficits. The higher functional ability of stroke patients may result in their higher physical activity. Gait speed is a functional parameter to differentiate between the ability of mobility of patients with stroke. However, if it is reflected in the time spent in an activity needs to be explored. Objectives: This pilot study attempts to explore time spent in PA by ambulatory stroke patients and compare time spent in different activity levels based on gait speed. Subjects and Methods: This pilot study recruited 26 ambulatory patients with stroke after obtaining informed consent. Their PA was recorded with ActiGraph wGT3X-BT for 1 day. Differences in time spent in the different level of PA were compared between people with gait speed ≤0.49 m/s and >0.49 m/s. Results: The result of the study shows that patients with stroke having gait speed ≤0.49 m/s had higher time spent in sedentary (686.02 ± 80.35 min/day) and light activity (612 ± 69.84 min/day) as compared to those with >0.49 m/s (646.42 ± 137.52 min/day and 593.57 ± 119.95 min/day, respectively). While time spent in moderate activity was higher in patients with stroke having gait speed >0.49 m/s (199.73 ± 111.17 min/day) as compared to those whose gait speed was ≤0.49 m/s (141.84 ± 76.75 min/day). However, this difference failed to demonstrate statistical significance. Conclusion: Patients with stroke were less physically active as compared to recommendations. Gait speed-based comparison demonstrates a nonsignificant difference between both groups. This suggests that factors other than gait speed may contribute to ambulatory stroke patients’ time spent in PA.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135845190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drugs for hypotensive anesthesia: A narrative review","authors":"TKrishna Prasad, RobinSajan Chacko, KSoundarya Priyadharsini","doi":"10.4103/injms.injms_18_23","DOIUrl":"https://doi.org/10.4103/injms.injms_18_23","url":null,"abstract":"Hypotensive anesthesia in specific types of surgeries brings about certain advantages such as decreased blood loss as well as better surgeon satisfaction regarding the surgical field. Of the various modalities by which this can be achieved, one of the most popular is by introducing a hypotensive agent to bring about the desired hypotension. Here, we aim to review a few studies regarding the use of various hypotensive agents for hypotensive anesthesia and try to come to learn the various modes of action of these said drugs, their specific indications or situations where they may be preferred as well as the various advantages and disadvantages that accompany their use.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135845192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}